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Feasibility of single-incision laparoscopic cholecystectomy for acute cholecystitis

World Journal of Gastrointestinal Endoscopy 2015年第19期7卷 1327-1333页

作者： taro ikumoto Hidetsugu Yamagishi Mineo Iwatate Yasushi Sano Masahito Kotaka Yasuo Imai Gastrointestinal Cancer Center and Institute of Minimally-invasive Endoscopic Care Sano Hospital Department of Diagnostic Pathology Dokkyo Medical University Department of Anatomic and Diagnostic Pathology Dokkyo Medical University

AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute ***: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to ***: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients(41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines(TG13) for the severity of cholecystitis, 86 and 14 patients had grade Ⅰ and grade Ⅱ acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients(89%). Conversion laparotomy was performed in 12 patients(12%). Postoperative complications of Clavien-Dindo grade Ⅲ or greater were observed in 4 patients(4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after ***: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion.

关键词： Acute cholecystitis Single-port accesssurgery Single incision laparoscopic cholecystectomy Single incision laparoscopic surgery Laparo-endoscopicsingle-site surgery

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Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions

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World Journal of Gastrointestinal Endoscopy 2014年第12期6卷 600-605页

作者： Santa Hattori Mineo Iwatate Wataru Sano Noriaki Hasuike Hidekazu Kosaka taro ikumoto Masahito Kotaka Akihiro Ichiyanagi Chikara Ebisutani Yasuko Hisano Takahiro Fujimori Yasushi Sano Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care Sano Hospital Department of Gastroenterology Kobe Minimally Invasive Treatment Center of Cancer Medical Oncology/Hematology Kobe University Graduate School of Medicine Department of Pathology Shinko Hospital

AIM: To assess the risk of failing to detect diminutive and small colorectal cancers with the "resect and discard" ***: Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancersand their endoscopic features were assessed. RESULTS: In total, we found 681 cases of diminutive(1-5 mm) lesions in 402 patients and 197 cases of small(6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal(SM) scanty invasive carcinomas, 1 and 1 were SM deeply invasive carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 ***: The risk of failing to detect diminutive and small colorectal invasive cancer with the "resect and discard" strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy.

关键词： Image-enhanced endoscopy Narrow-band imaging Resect and discard NICE classification Magnifying endoscope Colonoscopy SM-d

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